Use of In-Laboratory Sleep Studies in the Veterans Health Administration and Community Care.
Use of In-Laboratory Sleep Studies in the Veterans Health Administration and Community Care.
复制标题
实验室睡眠研究在退伍军人健康管理和社区护理中的应用。
DOI：
10.1164/rccm.201902-0313le
复制
发表时间：
2019
影响因子：
24.7
通讯作者：
Au,DavidH
中科院分区：
文献类型：
--
作者：
Donovan,LucasM;Coggeshall,ScottS;Spece,LauraJ;Griffith,MatthewF;Palen,BrianN;Parsons,ElizabethC;Todd-Stenberg,JeffreyA;Glorioso,ThomasJ;Carey,EvanP;Feemster,LauraC;Zeliadt,StevenB;Kirsh,Susan;Au,DavidH
方法我们获得了 2014 年 10 月至 2016 年 7 月期间进行的退伍军人首次睡眠研究的国家退伍军人管理局管理数据，这是社区护理从收费基础向选择过渡的时期。该运营评估项目由华盛顿特区退伍军人事务部退伍军人护理服务办公室赞助。根据 VA 手册 1058.05，这些活动是为了支持 VA 运营项目而进行的，并不构成全部或部分研究。因此，不需要机构审查委员会的批准。我们收集了有关 VA 和社区护理内进行的人口统计、诊断、药物和睡眠研究的信息，使用当前程序术语 (CPT) 代码来识别多导睡眠图（CPT 95808、95810 和 95811）或家庭测试（CPT 95800、95801 和 95806）。由于与 VA 的关系不同，我们选择先验地按费用基础和选择对社区护理进行分层。我们排除了有家庭测试禁忌症的患者，例如充血性心力衰竭、慢性阻塞性肺病、中风、神经肌肉无力和长期使用阿片类药物 (5)。我们还按地区提供测试。
MethodsWe obtained national VA administrative data for veterans’ first sleep studies performed during October 2014 to July 2016, a period of transition from Fee Basis to Choice for community care. This operational evaluation project was sponsored by the VA Office of Veterans Access to Care, Department of Veterans Affairs, Washington, DC. The activities were undertaken in support of a VA operational project and did not constitute research, in whole or in part, in compliance with VA Handbook 1058.05. Therefore, institutional review board approval was not required. We collected information regarding demographics, diagnoses, medications, and sleep studies performed within the VA and community care, using Current Procedural Terminology (CPT) codes to identify polysomnograms (CPT 95808, 95810, and 95811) or home tests (CPT 95800, 95801, and 95806). Because of divergent relationships with the VA, we chose a priori to stratify community care by Fee Basis and Choice. We excluded patients with home test contraindications, such as congestive heart failure, chronic obstructive pulmonary disease, stroke, neuromuscular weakness, and chronic opioid use (5). We also present testing by region.